MEMORANDUM OPINION
GUIN, District Judge.
Plaintiff brings this action pursuant to the provisions of section 205(g) of the Social Security Act, [hereinafter the Act], 42 U.S.C. § 405(g),
seeking judicial review of a final adverse decision of the Commissioner of Social Security [hereinafter Com
missioner]. Application for a period of disability and disability insurance benefits under sections 216(i) and 223 of the Social Security Act, as amended, was filed on December 31, 1998, as was an application for SSI as provided under Section 1601 of the Act, 42 U.S.C. §§ 1381
et seq.
These applications were denied initially and upon reconsideration. Request for a hearing before an administrative law judge [hereinafter ALJ] [Jerry C. Shirley] was granted, and a hearing was held February 17, 2001. The ALJ’s decision to deny benefits was handed down February 23, 2001. Plaintiffs request for review by the Appeals Council was denied February 13, 2002. An appeal to this court followed.
Plaintiff is a 51 year old female with an earned GED. As found by the ALJ she is unable to perform her past relevant work and has no transferable skills. The ALJ found that the medical evidence indicates that she has heart problems, carpal tunnel syndrome, hypertension, and back problems. He found her complaints of pain and the side effects of her medication unsupported by objective medical evidence.
In so doing he found that she is able to perform light work.
In reaching this opinion the court adopts the statement of facts in the decision of the ALJ, but not his conclusions, and the arguments presented in the plaintiffs brief.
The record shows Ms. Cronon suffers with, or has suffered with, the following physical impairments and treatment
therefore:
1)May 30, 1996, records from Kaweal Delta Health Care District: critical left main coronary stenosis and unstable angina — status post remote myocardial infarction — untreated hypertension — urgent coronary artery bypass graft x 2 with left internal thoracic artery to left anterior descending coronary artery and saphe-nous vein grafts to circumflex marginal arteries;
2) November 26, 1997, records from Kaweal Delta Health Care District: cardiac cauterization showed 70-80% stenosis of left main artery;
3) August 3, 1998, notes of Dr. Vinod Gupta, Diplómate American Board of Cardiovascular Diseases: assessment coronary artery disease, status post coronary artery bypass surgery, hy-percholesterolemia, hyperthyroidism, and mild congestive heart failure;
4) September 26, 2000, progress notes of Dr. John Mantle of Cardiology Consultants, P.C.: mild mitral valve regurgitation, mild aortic insufficiency, and tricuspid regurgitation — stable coronary artery disease — caution about “avoiding any strenuous work or heat conditions;”
5) May 21, 1997, notes of Dr. Peter C. Morrison of Orthopaedic Associates Medical Clinic, Inc: “considerable loss with a gas pattern at the L5-S1 disc” as shown by x-rays; — “severe degenerative changes;”
6) February 26, 1998, orthopaedic consultation notes of Dr. Cary Tanner of Visalia Medical Clinic, Inc: impression “significant lumbosacral degenerative disc disease;”
7) October 1, 1998, DX spine lumbosa-cral w/oblique at Kaweal Delta Department of Radiology: findings consistent with moderately advanced degenerative change at the L5-S1 level;
8) January 20, 1999, chest x-rays indicate degenerative change;
9) May 27, 1998, treatment notes Dr. Lancy Allyn & Associates for bilateral wrist pain and numbness: minimal thenar atrophy on left side — Tinnel sign bilaterally — wrist pain bilaterally with no report of hypesthesia with Phalen’s test — electro diagnostic studies showed slight right carpal tunnel syndrome and slight to moderate left carpal tunnel syndrome — ar-thralgia each wrist;
10) January 21, 1999, notes of Dr. Lan-cy Allyn: carpal tunnel release left side — moderate stenosis of carpal tunnel;
11) June 8, 1999, notes of Dr. Michael Wlasichuk of Physical Medicine & Rehabilitation Associates: nerve conduction tests evidence moderate to severe carpal tunnel syndrome on right, carpal tunnel syndrome of left with slowing of distal latency and nerve conduction velocity;
12) July 1, 1999, notes of Dr. Michael Wlasichuk of Physical Medicine & Rehabilitation Associates: assessment post bilateral carpal tunnel release and bilateral lateral epicon-dylitis — opined disability status “permanent and stationary” — wrist pain on palpation — significantly reduced handgrip strength — elbow pain bilaterally on palpation — tenderness at lateral epicondyle (elbow) — loss of 50% pre-injury capacity for lifting, pushing, pulling, grasping, and torquing — opined plaintiff qualified injured worker— should have vocational retraining.
As of October 3, 2000, plaintiffs prescribed medication included, in part, the following:
Atenolol
Vasotec
Zocor
Vicodin
Celebrex
Vioxx
Zanaflex
Lasix
Darvocet
Nitrostat
Although plaintiff has had the above-listed medications prescribed she had been unable to have the recommended lumbar CT myelogram and MRI prior to the decision of the ALJ due to lacks of funds and no insurance. Her income is limited to $680.00 a month received in workers’ compensation payments.
Plaintiff testified that she suffers from side effects of the prescribed medications. Nitroglygerine (Nitrostat) causes headaches. She has nausea and experiences frequent urination. She suffers with dizziness and is drowsy. She is reluctant to drive because some of the medications make her feel like she has lost touch with reality.
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MEMORANDUM OPINION
GUIN, District Judge.
Plaintiff brings this action pursuant to the provisions of section 205(g) of the Social Security Act, [hereinafter the Act], 42 U.S.C. § 405(g),
seeking judicial review of a final adverse decision of the Commissioner of Social Security [hereinafter Com
missioner]. Application for a period of disability and disability insurance benefits under sections 216(i) and 223 of the Social Security Act, as amended, was filed on December 31, 1998, as was an application for SSI as provided under Section 1601 of the Act, 42 U.S.C. §§ 1381
et seq.
These applications were denied initially and upon reconsideration. Request for a hearing before an administrative law judge [hereinafter ALJ] [Jerry C. Shirley] was granted, and a hearing was held February 17, 2001. The ALJ’s decision to deny benefits was handed down February 23, 2001. Plaintiffs request for review by the Appeals Council was denied February 13, 2002. An appeal to this court followed.
Plaintiff is a 51 year old female with an earned GED. As found by the ALJ she is unable to perform her past relevant work and has no transferable skills. The ALJ found that the medical evidence indicates that she has heart problems, carpal tunnel syndrome, hypertension, and back problems. He found her complaints of pain and the side effects of her medication unsupported by objective medical evidence.
In so doing he found that she is able to perform light work.
In reaching this opinion the court adopts the statement of facts in the decision of the ALJ, but not his conclusions, and the arguments presented in the plaintiffs brief.
The record shows Ms. Cronon suffers with, or has suffered with, the following physical impairments and treatment
therefore:
1)May 30, 1996, records from Kaweal Delta Health Care District: critical left main coronary stenosis and unstable angina — status post remote myocardial infarction — untreated hypertension — urgent coronary artery bypass graft x 2 with left internal thoracic artery to left anterior descending coronary artery and saphe-nous vein grafts to circumflex marginal arteries;
2) November 26, 1997, records from Kaweal Delta Health Care District: cardiac cauterization showed 70-80% stenosis of left main artery;
3) August 3, 1998, notes of Dr. Vinod Gupta, Diplómate American Board of Cardiovascular Diseases: assessment coronary artery disease, status post coronary artery bypass surgery, hy-percholesterolemia, hyperthyroidism, and mild congestive heart failure;
4) September 26, 2000, progress notes of Dr. John Mantle of Cardiology Consultants, P.C.: mild mitral valve regurgitation, mild aortic insufficiency, and tricuspid regurgitation — stable coronary artery disease — caution about “avoiding any strenuous work or heat conditions;”
5) May 21, 1997, notes of Dr. Peter C. Morrison of Orthopaedic Associates Medical Clinic, Inc: “considerable loss with a gas pattern at the L5-S1 disc” as shown by x-rays; — “severe degenerative changes;”
6) February 26, 1998, orthopaedic consultation notes of Dr. Cary Tanner of Visalia Medical Clinic, Inc: impression “significant lumbosacral degenerative disc disease;”
7) October 1, 1998, DX spine lumbosa-cral w/oblique at Kaweal Delta Department of Radiology: findings consistent with moderately advanced degenerative change at the L5-S1 level;
8) January 20, 1999, chest x-rays indicate degenerative change;
9) May 27, 1998, treatment notes Dr. Lancy Allyn & Associates for bilateral wrist pain and numbness: minimal thenar atrophy on left side — Tinnel sign bilaterally — wrist pain bilaterally with no report of hypesthesia with Phalen’s test — electro diagnostic studies showed slight right carpal tunnel syndrome and slight to moderate left carpal tunnel syndrome — ar-thralgia each wrist;
10) January 21, 1999, notes of Dr. Lan-cy Allyn: carpal tunnel release left side — moderate stenosis of carpal tunnel;
11) June 8, 1999, notes of Dr. Michael Wlasichuk of Physical Medicine & Rehabilitation Associates: nerve conduction tests evidence moderate to severe carpal tunnel syndrome on right, carpal tunnel syndrome of left with slowing of distal latency and nerve conduction velocity;
12) July 1, 1999, notes of Dr. Michael Wlasichuk of Physical Medicine & Rehabilitation Associates: assessment post bilateral carpal tunnel release and bilateral lateral epicon-dylitis — opined disability status “permanent and stationary” — wrist pain on palpation — significantly reduced handgrip strength — elbow pain bilaterally on palpation — tenderness at lateral epicondyle (elbow) — loss of 50% pre-injury capacity for lifting, pushing, pulling, grasping, and torquing — opined plaintiff qualified injured worker— should have vocational retraining.
As of October 3, 2000, plaintiffs prescribed medication included, in part, the following:
Atenolol
Vasotec
Zocor
Vicodin
Celebrex
Vioxx
Zanaflex
Lasix
Darvocet
Nitrostat
Although plaintiff has had the above-listed medications prescribed she had been unable to have the recommended lumbar CT myelogram and MRI prior to the decision of the ALJ due to lacks of funds and no insurance. Her income is limited to $680.00 a month received in workers’ compensation payments.
Plaintiff testified that she suffers from side effects of the prescribed medications. Nitroglygerine (Nitrostat) causes headaches. She has nausea and experiences frequent urination. She suffers with dizziness and is drowsy. She is reluctant to drive because some of the medications make her feel like she has lost touch with reality.
Pain is a constant problem. Nothing gets rid of it. It causes poor concentration. Due to the pain and side effects of medication her daily activities are limited. She can’t sleep or eat. She sits around the house watching television and dozing. She does what she can around the house but does not worry about the housework getting done. Her social life has been curtailed.
In finding that claimant was not disabled the ALJ found there “is not objective clinical evidence of a condition which could reasonably be expected to produce the level of pain, or other symptoms which the claimant allege [sic] preclude her from working.” He went to state the following:
While the claimant has the above medical condition(s), there is no objective medical evidence confirming the severity of the alleged pain and symptoms arising from that condition(s) or that the objectively determined medical condition(s) are of such severity that they can reasonably be expected to give rise to the alleged pain and other symptoms. Furthermore, no doctors have disabled claimant.
“The function of a reviewing court is limited to determining whether the Secretary’s findings are supported by substantial evidence considering the evidence as a whole.”
Mims v. Califano,
581 F.2d 1211, 1213 (5th Cir.1978). “Substantial evidence is more than a scintilla, but less than a preponderance.”
Bloodsworth v. Heckler,
703 F.2d 1233, 1239 (11th Cir.1983). It is such relevant evidence as a reasonable person would accept as adequate to support a conclusion.
Richardson v. Perales,
402 U.S. 389, 401, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842, 852 (1971). The court is still responsible for scrutinizing “ ‘the record in its entirety to ascertain whether substantial evidence supports each essential administrative finding.’”
Boyd v. Heckler,
704 F.2d 1207, 1209 (11th Cir.1983) (quoting
Walden v. Schweiker,
672 F.2d 835, 838 (11th Cir.1982)). The Eleventh Circuit has gone on to state the following:
Our limited review does not, however, mean automatic affirmance, for although we defer to both the Secretary’s fact-finding and her policy judgments, we must still make certain that she has exercised reasoned decision making. To this end, we evaluate the Secretary’s findings in light of the entire record, not only that evidence which supports her position.
Owens v. Heckler,
748 F.2d 1511 (11th Cir.1984).
The court must further consider whether the decision of the Commissioner contains a material error of law. In
Walker v. Bowen,
826 F.2d 996, 999 (11th Cir.1987), the court held:
Despite this limited review, we scrutinize the record in its entirety to deter
mine the reasonableness of the secretary’s factual findings.
Bridges,
815 F.2d at 624;
Arnold v. Heckler,
732 F.2d 881, 883 (11th Cir.1984). No similar presumption of validity attaches to the Secretary’s legal conclusions, including determination of the proper standards to be applied in evaluating claims.
Wiggins v. Schweiker,
679 F.2d 1387, 1389 (11th Cir.1982).
Having evaluated the evidence, the court holds that the evidence does not support the decision denying disability benefits. Improper legal standards were applied. The ALJ has misread or misstated contents of the record.
Whenever a claimant asserts disability through testimony of pain or other subjective symptoms, the Eleventh Circuit standard requires:
1) evidence of an underlying medical condition and either
2) objective medical evidence confirming the severity of the alleged pain arising from that condition or
3) that the objectively determined medical condition is of such severity that it can reasonably be expected to cause the alleged pain.
Holt v. Sullivan,
921 F.2d 1221, 1223 (11th Cir.1991). See also
Elam v. Railroad Retirement Board,
921 F.2d 1210, 1215 (11th Cir.1991);
Lamb v. Bowen,
847 F.2d 698, 702 (11th Cir.1988);
Hand v. Heckler,
761 F.2d 1545, 1548 (11th Cir.1985).
In
Brown v. Sullivan,
921 F.2d 1233 (11th Cir.1991), the court said:
The claimant’s subjective testimony supported by medical evidence that satisfies the standard is itself sufficient to support a finding of disability.
Hale v. Bowen,
831 F.2d 1007, 1011 (11th Cir.1987);
MacGregor,
786 F.2d at 1054;
Landry v. Heckler,
782 F.2d 1551 (11th Cir.1986). If the Secretary decides not to credit such testimony, he must discredit it explicitly,
MacGregor
at 1054, and articulate explicit and adequate reasons for doing so.
Hale,
831 F.2d at 1011. Failure to articulate the reasons for discrediting subjective pain testimony requires, as a matter of law, that the testimony be accepted as true.
Cannon v. Bowen,
858 F.2d 1541, 1545 (11th Cir.1988);
Hale,
at 1011;
MacGregor,
at 1054.
Brown v. Sullivan,
921 F.2d at 1236. As in
Brown,
Ms. Cronon’s subjective testimony in the present case is well supported by objective medical evidence (x-rays showing severe degenerative changes, atrophy, nerve conduction tests, tenderness, pain on palpation, reduced handgrip strength, muscle spasms
) of underlying conditions (heart problems, carpal tunnel syndrome, hypertension, and back problems)
which could reasonably be expected to produce her pain. Although the ALJ states there is no objective evidence, the record as outlined belies the statement.
The ALJ’s statement that “no doctors have disabled
claimant” ignores the opinion of Dr. Wlasi-chuk that her disability status relative to the failed carpal tunnel syndrome releases is “permanent and stationary.” The medical evidence establishes that claimant’s pain testimony is credible.
Objective evidence establishes conditions which could reasonably be expected to produce her pain. She has suffered and continues to suffer with pain. The ALJ’s failure to articulate explicit and adequate reasons for rejecting this testimony requires that it be accepted as true.
Brown v. Sullivan,
921 F.2d at 1236 (citing
Hale v. Bowen,
831 F.2d at 1011).
There is abundant, uncontradicted clinical and objective evidence to establish the credibility of plaintiffs pain. No doctor has doubted her credibility. Rather multiple prescriptions for strong pain medicine have repeatedly been written. Accordingly, the opinion of the Commissioner is due to be REVERSED.
The ALJ’s determination that plaintiff is capable of performing light work
is additional error. Vocational expert Peacock testified that if plaintiffs testimony is credible regarding her pain and side effects of medication there is no work she can do. Record testimony follows:
Q. Okay. Why would that be? Can you be a little more specific?
A. Based on the testimony, the problem, should His Honor find it credible, related to her heart, the symptoms from her high blood pressure, the inability to use her hands as she has described as a result of the carpal tunnel, and the back pain that she has described, that would prevent any kind of work.
ALJ: I’m sorry. Would you say that again, Mr. Peacock?
VE: The difficulty she has described with her heart—
ALJ: What specifically?
VE: The inability to do anything over a period of time, as I understand it,
sustain any activity. The high blood pressure, the frequency, the problems of controlling it, up and down, as I have in my notes. The carpal tunnel where she said she could only occasionally at times lift up to seven pounds, I believe. And the inability to sit and move about as a result of her low back or back pain — I’m sorry, it’s the upper back.
ALJ: I think she said upper back and low back.
ATTY: Yes, Your Honor.
ALJ: Would you agree?
Under questioning the vocational expert testified plaintiff would be unable to perform her past work. Any jobs available in the economy open to her would be limited to those involving occasional use of her hands. Clearly “light work” would require more from plaintiff than her doctor has adjudged her capable of performing; her hand disability resulting from the failed carpal tunnel syndrome releases is “permanent and stationary.”
The decision of the Commissioner is due to be REVERSED.
Additionally, new evidence which was submitted to the Appeals Council, but not included in the record,
further substantiates plaintiffs disabled status. Were the case remanded a finding of disability would be documented by the following evidence submitted to this court as attachments to plaintiffs brief:
1) Records from plaintiffs treating orthopedist Dr. H. Chester Boston based on MRI’s, films, and examinations showing myoligamentous injury of lumbar spine;
2) June 6, 2001, letter from Dr. Boston opining that Ms. Boston is medically disabled as a result of degenerative disc disease complicated by her history of heart disease and emphysema;
3) MRI report of lumbar spine dated April 30, 2001, showing disc desiccation and central disc protrusion at L5-S1 which contacts the proximal SI nerve roots bilaterally;
4) Chest x-ray dated April 24, 2001, showing emphysematous aging chest with post-CABG changes;
5) MRI of thoracic spine dated April 24, 2001.
The above-listed new evidence did not exist at the time of the hearing.
It contains test results (MRI’S, films) considered important by the ALJ. The new evidence shows the extent of plaintiffs degenerative disease. Were this evidence considered there is a “reasonable certainty”
the evidence would change the result at the administrative level.
Dr. Boston’s letter opining plaintiffs inability to work is based on degenerative disease complicated by coronary artery bypass surgery
and pulmonary emphysema. His records clearly apply to the period prior to the date of the ALJ’s decision and, standing alone on the basis of clear evidence, mandate REVERSAL of the Commissioner’s decision. Dr. Boston’s opinion that she is disabled supplies the ALJ’s dubious requirement that a treating physician certify plaintiff disabled in so many words. The ALJ’s opinion ignores the fact that plaintiff is drawing workers’ compensation pay for permanent disability. Receipt of workers’ compensation payments requires a physician’s certification and is proof that somewhere there exists just such a certification.
The new evidence clearly relates to the time before the ALJ’s decision. Although it is new evidence it documents conditions that existed for some time and shows that her impairments are even more severe than previously shown by the medical records.
For the reasons set forth above the decision of the Commissioner is REVERSED. An order consistent with this opinion is being entered contemporaneously herewith.
ORDER
In conformity with and pursuant to the memorandum opinion entered contemporaneously, it is
ORDERED, ADJUDGED and DECREED that the decision of the Commissioner of Social Security be and it hereby is REVERSED, and the case is REMANDED to the Commissioner with instructions that the plaintiff be granted the benefits claimed. It is
FURTHER ORDERED, ADJUDGED and DECREED that the motion to remand is DENIED, the court having reversed the decision of the Commissioner.
It is FURTHER ORDERED that pursuant to the reversal the Commissioner withhold from payments which he may determine are due plaintiff under this order an amount not to exceed 25 percent of the total amount of disability benefits to which the plaintiff is entitled, pursuant to the provisions of section 206 of the Social Security Act, as amended 42 U.S.C. § 406(b). The Commissioner is directed to advise the court of the amount withheld so that the matter may be set for final determination of the amount of attorney’s fees to be allowed plaintiffs counsel for services rendered in representing the plaintiff in this cause.